In the future children are "Uglies" until they turn 16. On their 16th birthday they get to become "Pretties" by surgery. Tally, a rule breaking teen befriends a girl named Shay. Shay is unsure about the surgery and runs away. When Tally's 16th birthday comes Tally must make an awful decision:she must either betray and turn in Shay on never turn "Pretty" and be "Ugly" forever.